Earlier this week, we began a discussion of the alleged shortcomings in the postmortem medical examination of infants and children. Not only is the field of forensic pathology chronically underfunded and unexamined, there is a significant shortage of specialists who are trained in examining small children and infants to determine whether they were subjected to a sexual assault and to find the cause of death.

This is significant because of the significant differences between the bodies of adults and infants, says medical examiner Jon Thogmartin. "Adults are generally tougher and harder to kill than a small child. Particularly an infant," he said. "So you're looking for very subtle signs of trauma or pressure, or small amounts of bleeding that could potentially cause a kid severe illness or death."

This can be difficult for any forensic pathologist, even if they specialize in infant and child examinations. After all, they are people, often with children of their own, so to see what appears to be a brutally and fatally abused child on their examining table is no doubt traumatic, no matter how many they have seen. This can lead many examiners to rush to a finding that physical or sexual abuse caused the child's death.

But a growing body of medical evidence is shedding light on ailments known as "mimics", which can cause the kinds of bleeding and bruising that have long been considered solid evidence of child abuse. Examiners may not be aware of these ailments, leading them to come to an incorrect conclusion about the child's cause of death.

This wrongful presumption toward abuse creates a huge roadblock for defendants and their attorneys, who must now defend against two damning pieces of evidence, according to Justice Stephen Goudge. "The first: who had care of the infant in the hours leading up to the death...And secondly, the forensic pathology," he said. "If the autopsy findings are flawed, then the risk of a miscarriage of justice is high."

Source: NPR, "The Child Cases: Guilty Until Proved Innocent," A.C. Thompson, Joseph Shapiro, Sandra Bartlett and Chisun Lee, 28 June 2011